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Ovc
 

Ovc

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    Ovc Ovc Presentation Transcript

    • OVC programme overview SOURCE: South Africa HIV/AIDS response stakeholder interviews; Project team analysis
          • OVC policy in South Africa is amongst the best in the world
          • OVC care is a growing problem in South Africa due as the number of HIV/AIDS OVCs continues to increase
          • Complex programme with a large number of implementers
          • Poor evaluation and data collection due to lack of integration across sectors and poor data collection capabilities
          • Strong policy drives action (i.e., the Child Care Act) however front line staff lack training/understanding of all elements to properly implement
          • Coordination is poor as although t here are a number of forums at all levels, however provincial and lower forums are not adequately funded or staffed, leading to poor functionality
          • Civil society leads implementation but lack capabilities and capacity
          • Government and development partners both fund implementers to deliver core programmes
          • Government provides child care and foster care grants though financial resources are not sufficient to care for the actually numbers of OVCs and donor funding is levelling off
          • Government lacks an overview of the real number of OVCs
      Overview Structure Implemen-tation model Financing
    • Coordination complexity archetypes – South Africa (province) 1 Includes provider-initiated VCT SOURCE: South Africa HIV/ AIDS stakeholder interviews Medium High Low Extreme Intervention type (primary)
        • Clinical
        • Clinical
        • Clinical/ Behavioural
        • Behavioural
      Number of funders
        • 0-2
        • 3-5
        • >10
        • 3-5
      Number of implementers
        • 1
        • 2-10
        • 11-25
        • >25
      Examples of programs in archetype
        • N/A
        • N/A
        • PMTCT
        • ART
        • MMC
        • VCT
        • OVC
        • BCC
    • OVC programme is highly complex (1/2) SOURCE: South Africa HIV/AIDS response stakeholder interviews 1 National Action Committee for Children Affected by AIDS; 2 Provincial Action Committee; 3 District Action Committee 4 Minister of Social Development Provincial National District NGOs NGOs NGOs National NGOs Implementers PACCA 2 DACCA 3 NACCA 1 HIV Coordinator Children’s Provincial Coordinator Combined in some provinces e.g., Northern Province District Coordinator Multi-sectoral coordi-nation of OVC services (chair is HIV Director – also sits on SANAC) HIV Directorate Children’s Directorate MSD 4 =>DG Premier=>DG=> Head of Department Child protection services Community-based, early intervention District tenders out services to CBOs PRELIMINARY ILLUSTRATIVE NGOs NGOs NGOs Social workers & residential institutions NGOs NGOs NGOs Donors/ foundations NGOs NGOs NGOs OVC leads NGOs NGOs NGOs NGOs/COSs provide community services NGOs NGOs NGOs Provincial NGOs NGOs NGOs NGOs Private sector
    • OVC programme is highly complex (2/2) Low Medium High Extreme Funders
        • DSD provides majority of funding
        • 10% of USAID funding goes towards OVC, funding mainly community-based services and health systems strengthening (e.g., M&R systems, evaluation, training programmes). Funding goes to NGOs (e.g., NACCW/ Isibindi) or DSD via Pact SA (umbrella grant management organisation)
        • Some private foundations provide funding as well (e.g., DG Murry)
      Implementers
        • Government employs social workers in each district, and manages child and youth care centres (i.e., residential care)
        • All community-based care is done by NGOs/ small CBOs: funding is from international donors/ foundations (e.g., PEPFAR) or via district tenders
      Size
        • ~500,000 – 600,000 children currently in statutory foster care
        • 90,000 social workers, each with enormous case loads of ~400 – 500 children each
        • Approximately 3.8 million children have lost one or both parents to HIV
        • Ability to provide care in the community (i.e., community-based child and youth care workers working in the ‘life space’ of the child) is required
        • This has resulted in hundreds of small CBOs providing care in each province, often starting out as volunteer organisations/ child care forums & evolving into service delivery as gaps are identified
        • Coordination and community-level integration is critical – certain provinces are better organised than others (e.g., in KZN there are well organised networks such as the Cindi network, while in others there is virtually no coordination)
      Capabilities required SOURCE: USAID, stakeholder interviews, DSD reports PRELIMINARY
    • Key programme players and roles SOURCE: South Africa HIV/AIDS response stakeholder interviews
        • DSD developed Child Care Act
        • NACCA led on development of OVC policy (in line with Child Care Act)
        • DSD allocates resources ac-ross provinces
        • PEPFAR provides funding to DSD through Pact SA
        • Target set centrally and disaggregated to district level
        • Provincial DoH develop operational plans
        • Social workers provide statutory services
        • No community-based youth and child care workers
        • National and provincial databases (poorly integrated)
        • HSRC – annual household survey
      Government
        • PEPFAR and some private foundations (e.g., DG Murry) provide OVC funding
        • Limited involvement at provincial level
        • Largely fund innovative models (e.g., Isibindi) which can then be scaled up
        • All partners monitor & report to donors (and are required to supply data to district gvt)
        • Fund ad-hoc independent evaluation (largely prog-rammatic, not comparative)
        • Local University provided TA for development
      Donors
        • NGOs receive funding directly from donors (e.g., Isibindi) or via district gvt tenders
        • N/A
        • Child care forums are volunteer-led
        • Community services pro-vided by NGOs and CBOs
        • RCFF, Child Welfare, RFM are child protection agencies (NGOs with a mandate to do statutory work)
        • All partners monitor & report to donors (and are required to supply data to district gvt)
        • N/A
        • Very active input/ challenge policies/ strategies (highly consultative) 1
      Civil Society organisations/ NGOs PRELIMINARY Strategy/ Policy Resource allocation (budgeting) Planning Implementation Monitoring and reporting Evaluation
    • Programme landscape 1 National Information System for Welfare 2 Provincial Information Management System for Welfare SOURCE: South Africa HIV/AIDS response stakeholder interviews
        • Social workers delivering statutory services
        • Community development workers do prevention and early intervention
        • Child and youth care workers – employed by gvt in institutions, in community programmes they are employed by NGOs (PEPFAR partners care for ~500,000 orphans)
        • Children’s Act was developed by DSD, with extensive, lengthy consultation with multiple stakeholders
        • Main change was the focus on family preservation, prevention and early intervention
        • Development started in ~1995, with the first part accepted by parliament in 2005, and amended in 2007
        • Norms and standards only established in 2008/09 – this is when the Act came into force
        • DSD costed the Child Care Act – focused on social workers/ statutory services, not C hild and Youth Care workers, prevention or early intervention
        • DSD tends to play a very active role in allocating donor resources/ choosing partners (e.g., represented on all PEPFAR tech eval committees, full transparency over donor resources)
        • Planning is done at a provincial level, who decide on targets and disaggregate them to the districts
        • Very weak
        • Only donor funded programmes really do robust M&R
        • DSD has two systems at a national (NISWEL) & provincial (PIMWEL) level which are comp-letely unintegrated
        • Poor quality data collection at a district level
        • This data is fed into provincial offices, which lack the capacity to consoli-date/analyse the data properly due to high turnover/ vacancies
        • Data that is collected is not incorporated into planning (e.g., maternal orphans database)
        • Very weak
        • Very limited internal research capabilities
        • Ad hoc studies are commissioned (paid for by donors/ PACT), e.g., evaluation of Isibindi currently underway – PEPFAR funded
        • Mix of local and oversees organisations do the evaluation
        • Programme evaluation rather than comparative evaluation
      PRELIMINARY Strategy/ Policy Resource allocation (budgeting) Planning Implementation Monitoring and reporting Evaluation
    • Key forums in OVC SOURCE: South Africa HIV/AIDS response stakeholder interviews PRELIMINARY SANAC Programme Implementation Committee
        • Who : Lead by DoH, Provincial AIDS Councils, District / Local, AIDS Councils/ Multi-Sectoral Action Teams
        • How often : Every 2 months
        • Objectives : highest body providing strategic and political guidance to government on HIV and AIDS and STIs
        • The forum is considered to be well functioning
        • Who : national level government, large CSOs, development agencies and donors
        • How often : Steering committee: every 6 weeks; general reference teams: 2 times a year
        • Objectives: provide input to a national coordinated response to OVCs
      NACCA
        • Functional arena for discussion and planning
        • Strength of lobbyist stems from independent funding and resulting freedom of speech
        • Who : District Action Committee for Children Affected by HIV and AIDS (DACCA)
        • How often : Varies
        • Objectives : coordinate area Forums/ Committees/Community Fora were proposed
      DACCA
        • Generally underperforming
        • High level of government control (chooses attendees, sets agenda), as DACCAs have no independent funding sources
        • Political infighting amongst NGOs discourages involvement
        • Who : provincial level government, large CSOs, development agencies and donors
        • How often : Once a month
        • Objectives : provide input to a provincial coordinated response to OVCs
      PACCA
        • PACCA is able to convene a representative group across sectors
        • Integrity is challenged by government control and limited civil society input
      Forum Description Strengths and challenges
    • Key forums in OVC (2/2) SOURCE: South Africa HIV/AIDS response stakeholder interviews LACCA
        • Who: Local Action Committee for Children Affected by HIV and AIDS
        • How often: Varies
        • Objectives: coordinate local Forums, Committees, and Community Fora
        • Generally ineffective and often nonexistent
        • Not adequately funded or staffed
        • Who: Led by DSD
        • How often:
        • Objectives: promote coordination between all stakeholders at all levels
        • TBD
      Provincial/District Action Committees
        • Who: Led by DSD
        • How often:
        • Objectives: facilitate co-operation, co-ordination and integration of all government spheres/ departments and CSOs
        • Provincial equivalent: Provincial Child Care and Protection Forums
        • Child protection/care forums are functional at the national level but failing at the provincial level
      National child care and protection Forum
        • Who: Led by DSD, Provincial Action Committees, District Action Committees /Child Care Forums
        • How often:
        • Objectives: promote coordination between all stakeholders at all levels
        • TBD
      National Action Committee for Children Affected by HIV and AIDS Forum Description Strengths and challenges PRELIMINARY
    • The Isibindi programme offers a new model of donor funding SOURCE: South Africa HIV/AIDS response stakeholder interviews ; NACCA
        • Designed by the National Association of Child Care Workers
        • Implemented in over 55 sites in 8 provinces by over 40 partner organizations
        • Run on a ‘social franchise’ basis
        • Five-way partnerships link the DSD at provincial level, the donor, the community, implementing organisations and the NACCW
        • Standardised monitoring and evaluation system collates data and maintains accountability
      PEPFAR
        • Funded Isibindi when it was an innovative new community model
        • Tested and evaluated it over the course of a few years
        • Now government plans to take ownership and roll it out across the country as a standard model of care
      NACCA PRELIMINARY
    • Isibindi’s integrated community model is highly effective will a number of positive spillover effects SOURCE: South Africa HIV/AIDS response stakeholder interviews ; NACCA PRELIMINARY
        • Operating Model
        • Unemployed community members are screened, selected, trained and deployed as child and youth care workers
        • Mentorship is provided by experienced social service professionals
        • Workers blend household support with care and development
        • Main beneficiaries are children and families
        • Organizations are assisted to grow and access further resources
        • Communities are strengthened through the injection of skills and resources
        • Workers are set on a career path in a recognized profession
        • Safe Park Model
        • Currently being replicated across South Africa by over 20 organisations
        • Provides places for children to play safely under adult supervision
        • Girl Child Program
        • Female children and household heads are offered an intensive program of self-development and career information and planning
        • Care for Caregivers
        • Provides group and individual counselling to child and youth care workers
        • Child Protection Program
        • Vulnerable victims of sexual abuse are provided therapeutic support
        • Disability Program
        • Screening and assessment program providing access to remedial therapy and (where possible) assistive devices
      “ No one is born a good citizen; no nation is born a democracy. Rather, both are processes that continue to evolve over a lifetime. Young people must be included from birth. A society that cuts off from its youth severs its lifeline.” - Kofi Annan